NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

Which statement is true regarding the treatment of SIHD with Nitroglycerin formulations?

1. Long acting nitrates require a 24-hour nitrate free period.

2. Short acting nitrates are preferred for long-term management.

3. Long acting nitrates require a 10-12 hour nitrate free period.

4. All nitroglycerin formulations can be used with PDE-5 inhibitors.

The correct answer is: Long acting nitrates require a 10-12 hour nitrate free period.

Long-acting nitrates, such as nitroglycerin patches, typically require a nitrate-free period of 10-12 hours to prevent tolerance buildup. This statement is true because taking nitroglycerin continuously without a break can lead to decreased effectiveness of the medication due to the development of tolerance. It is essential for patients using long-acting nitrates to have a consistent nitrate-free period to maintain the efficacy of the treatment. Option A is incorrect because the 24-hour nitrate-free period is excessive and not generally required for long-acting nitrates. Option B is incorrect because short-acting nitrates are typically used for immediate relief of angina symptoms and not for long-term management of stable ischemic heart disease (SIHD). Option D is incorrect because not all nitroglycerin formulations can be safely used with PDE-5 inhibitors. Combining nitroglycerin with PDE-5 inhibitors can lead to severe hypotension and is generally contraindicated.